The FT reports this morning that:
The NHS has for the first time asked the private sector to help purchase billions of pounds worth of services for hospitals and GPs.
NHS England on Tuesday advertised for companies to compete for work worth at least £5bn advising the new doctor-led clinical commissioning groups, which spend more than two-thirds of the NHS budget buying care for patients.
Let me break those statements down.
First, let's consider the farce of it costing £5 billion to support GPs make decisions. The whole of the GP service in the UK costs about £12.5 billion (9% approximately of the total £137 bn spend). So we're now going to spend a sum equivalent to 40% of that supporting buying decisions by GPs over 5 years?
That does not make sense on any level. Firstly, because in that case GPs are clearly not in charge of this activity in that case; the sheer scale of it suggests that they can't be. And secondly the immediate thought is, surely this could be better spent?
Second, the purpose of this spend is to “create a competitive market in the buying of healthcare services". In other words, this is £5 billion to take money out of the NHS and into the private sector.
This is the privatisation agenda that the government has always denied exists written large all over the future of healthcare in this country.
NB Updated to make clear the spend was over 5 years at 10.30 am 26.2.14
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You obviously didn’t read the article – or you’re being intentionally disingenuous Richard! The £5bn is over 5 years – therefore only £1bn pa. I thought you were an accountant!
Ah…that was an error
We all make them
So you think a billion a year IS acceptable? The principle point that these whole reforms were purportedly about putting GPs into the driving seat is shown for the lie that it always was. It has always been about privatising the NHS. By 2015 it will almost certainly be irreversibe.
You´ll note the almost total silence from labour, at least about the NHS.
Locally, the NHS hospital CT and MRI scanners are busy scanning private patients.
The physio department is ticking over, many patients are now sent to independent physio companies (5-free-5-costly), doubtless there is a fee changing hands.
I note the data sale has been put on hold. My GP practice has a large heap of opt-outs to cope with. Maybe someone at NHS England should tell them that the opt-outs will be massaged away in the near future?
It often seems to me that our political servants should take lessons on democracy, or maybe we should take lessons on how to recognise blatant liars?
NeilT –
Please will you stop and think carefully for one moment.
Is £1billion a year perfectly acceptable then?
Will patients actually benefit from this largesse?
I don’t think so. The money can be spent far more effectively on front line services. But then my opinion counts for naught, because after all Mr “Money no Object” Czmeron and other Tory Droogs have made this ridiculous decision to add to add to the others that are forming a festering heap at the Palace of Westminster.
A I suggest that rather than trying to score a quick pyrolitically
Sorry hit button in haste brought on by sheer exasperation!
NeilT — Please will you stop and think carefully for one moment.
Is £1billion a year perfectly acceptable then?
Will patients actually benefit from this largesse?
I don’t think so. The money can be spent far more effectively on front line services. But then my opinion counts for naught, because after all Mr “Money no Object” Cameron and his Tory Droogs have made this ridiculous decision to add to the others that are forming a festering heap at the Palace of Westminster.
I would urge you to think about the bigger picture rather than trying to score quick political points.
This is not for the medical services though, is it.
Just for admin for CGS’.
Yet more places run by the usual offshore based tax avoiders.
My trust is in the process of tendering for certain services, which can then be split up into different “parcels” and then subcontracted out to other providers, who can in turn subcontract – which means there are lengthy expensive legal and financial agreements having to be drawn up and payments going up and down the chain – all at the expense of patient care. As an NHS finance director said to me – yes it is crazy but at least it keeps the accountants busy !
Nice to hear it from the frontline, as it were, Trust Governor. But truthfully, anyone whose followed the privatisation/marketisation of public services could have told you this would happen. Indeed, its been known about for years.
For example, back in the 1990s me and some colleagues were undertaking research in local government at a time when the first wave of contracting out and privatisation was in full swing. Every local authority we visited – and it was a good spread across England – reported the same thing. A significant increase in contract related administration AND a reduction in the standard of service received. None of those costs were allowed to be counted against the assumed or claimed cost savings from contracting out. And nobody wanted us to publicise what was happening, either, usually because of fear of being “punished” in some way by central government.
For what it’s worth you’d find exactly the same occurring across central government departments – witness the current debacle over PIPs. Again little if any effort is put into trying to cost how much the processes and procedures associated with designing, implementing and, most importantly, maintaining, contracting out costs. In reality, if these costs were set against the claimed/actual savings from contracting out I doubt whether there are any savings – efficiency or otherwise – at all. Unfortunately, you’re about to find that out too.
In many ways it’s irrelevant whether this is £1 or £5 billion a year, Richard. The key point, as you highlight, is that this is billions being stripped out of the NHS budget that could have gone into frontline MEDICAL services, but will now find its way onto the books of commercial companies providing all kinds and advisory services.
But worse than that, with fifteen months to go before an election (plus the hiatus period after that), this signals effectively two years in which the zealots of privatisation and marketisation can break apart the unified NHS and its existence as a PUBLIC service. Furthermore, we can expect any attempt to withstand that by any group within the NHS to be referred to Monitor by the organisations that take on that work.
Meanwhile, in tandem with the above, we can expect a PR blitz from the government and the various representative bodies of the privatised NHS, directed at demonstrating how much NHS services are improving now they’ve been opened up to competition. Simultaneously we can expect a clamp down on any source or potential source of news that might be “off message”. God help anyone who tries to whistle blow!
Ultimately though, what the Tories have managed to do while in government, with absolutely no prior warning or popular mandate, will mean that by the next election not only have the created a US style higher education system in England and Wales, but also a US style health service. As anyone who knows much about either system in the US can tell you, the benefits of such systems accrue to the few, while the downsides and drawback accrue to the many. And of course, none – NONE – of this would have been possible without the Lib Dems, .
What a truly shameful legacy. And one that Shirley Williams in particular, should never, ever be allowed to forget.
The Lib Dems have betrayed an honourable tradition as having overseen the root reforms that ledt to the welfare state.
Yes Ivan, agree absolutely about the miserable Lib Dems, and their pathetic connivance in the backdoor privatisation of the NHS. If politicians whine about public apathy about politics they should look in the mirror; message to “progressive” politicians: try not betraying 80% of the people who voted for you by jumping into bed with the political right. Shirley Williams should hang her head in shame, as should all the Lib Dems.
Yet again, taxpayers are lining privateers pockets. Of course, with the increasing closure of A+E wards and more and more cuts to the service, the intention is to cause more and more chaos until the system breaks down.
They will then have the perfect excuse of handing the whole NHS lock, stock and barrel to the privateers.
I firmly believe this to be the intention.
To: Stevo!!
“..the intention is to cause more and more chaos until the system breaks down.
They will then have the perfect excuse of handing the whole NHS lock, stock and barrel to the privateers.”
You are absolutely right and we saw it coming. What on earth can we do about it??
At least, Andy Burnham has taken on board the locking-in process for these NHS contracts which will happen if the EU-US Free Trade Agreement (TTIP/TAFTA) is signed. The EU Commissioners are rushing this treaty through so we are dependent on the US Senate and Congress to reject.
Andy Burnham is off to Brussels to lobby for the NHS to be left out of the treaty but I shouldn’t think that will cut any ice with the neoliberal fanatical ideologues that constitute the Commission or Mrs Merkel.